Individual
DIDA K. GANJOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3060 MITCHELLVILLE RD, SUITE 104, BOWIE, MD 20716-1389
(301) 218-4220
(301) 218-4330
Mailing address
3060 MITCHELLVILLE RD, SUITE 104, BOWIE, MD 20716-1389
(301) 218-4220
(301) 218-4330
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0036532
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095591400
—
MD
Enumeration date
07/19/2006
Last updated
12/23/2024
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